Worldwide there is an increased pressure on imaging departments to measure and improve the quality of care. In the United States, this is driven by regulatory agencies, the Centers for Medicare and Medicaid Services (CMS), payers as well as professional societies.
Common key performance indicators (KPIs) are based on quantities such as equipment utilization, idle time or patient throughput. By now, even first benchmarks for quality improvement became available which allow for a comparison between different sites. Most of the KPIs are derived from device logs or clinical information systems (i.e. non-image data).
Next to non-image data, the images themselves provide a broad range of options to define meaningful quality metrics. One example is the adherence to guidelines. Imaging departments typically define scan planning and/or patient positioning guidelines which are used by the technician in order to plan the geometry of a scan. These guidelines ensure that the anatomy of interest is completely covered and that an unnecessary dose exposure is avoided. Incorrect scans can reduce the diagnostic value of an image, and can make a re-scan necessary.
Another (even more fundamental) issue is the correctness of anatomical information. While the Digital Imaging and Communications in Medicine (DICOM) standard provides multiple options to indicate the scanned anatomy (e.g. Body Part Examined value or Anatomic Region Sequence code), this information is not reliable. Errors in the anatomical information could have a negative impact on the clinical workflow, as e.g. relevant prior scans are more difficult to identify. Furthermore, it makes a statistical evaluation of the performed scans in a department impossible.